Research suggests that childbearing does not necessarily cause psychological distress among teenagers. Dr. Stefanie Mollborn of the University of Colorado and her team investigated stress and depression using a large group of teenage girls and adult women.

In the Journal of Health and Social Behavior, they explain that teenage mothers’ high depression rates have received “considerable research attention” in small studies, but a larger study of adolescent childbearing and depression was needed.

So they used figures from two large long-term surveys, the U.S. National Longitudinal Study of Adolescent Health and the Early Childhood Longitudinal Study-Birth Cohort. The participants completed questionnaires to measure depression, although the term “depression” was avoided.

Questions covered areas such as how often the participants found things that did not usually bother them to be bothersome, how easily they could shake off feeling blue, and whether they had trouble concentrating. Analysis showed that teenage mothers had higher levels of depression than other teenagers or adult mothers, but the experience of teenage childbearing did not appear to be the cause. “Rather, teenage mothers’ depression levels were already higher than their peers’ before they became pregnant, and they remained higher after childbearing and into early and middle adulthood,” the researchers report.

But the results did suggest that the combination of poverty and existing distress was a good predictor of teen pregnancy. “In this group, depression markedly increases the probability of becoming a teenage mother,” they report. However, for the majority of teenage girls, the link between depression and subsequent teenage pregnancy is “spurious,” they believe.

Dr. Mollborn commented, “Psychologically distressed girls are at risk for teen childbearing, even if the two things usually do not cause each other. This could help educators and clinicians identify at-risk adolescents.”

Dr. Diane Merritt of the Washington University School of Medicine in St. Louis says that screening for symptoms of depression or distress should be part of normal health screening for all teenagers. “Talking to teenagers about their sexuality and responsible behavior (such as birth control) is key,” she commented, adding that having long-term goals and good self-esteem are among the best ways to prevent teen pregnancy.

Teenage childbearing may be “a positive adaptive mechanism for humans raised in a hostile environment,” suggests Dr. Julie Quinlivan of the University of Melbourne, Australia. This makes sense from an evolutionary perspective, she believes, because “life history theory suggests that in risky and uncertain environments the optimal reproductive strategy is to reproduce early in order to maximize the probability of leaving any descendents at all.”

Among teenage mothers who have planned their parenthood, some positive behavioral changes are often observed, Dr. Quinlivan adds. For example, many teenagers reduce risk-taking behavior regarding cigarettes, alcohol, and marijuana. “Once pregnant, rates of consumption are usually lower compared with their non-pregnant peers or even their own personal pre-pregnancy rates of consumption,” she writes.

Given that teenage motherhood is not simply going to vanish, her opinion is that we should “focus research and services on validated interventions that may assist teenage mothers fulfil their ambitions of parenthood and simultaneously provide the best outcomes for their offspring,” such as teenage pregnancy clinics and regular home visits by nurses.

Further work based on the National Longitudinal Survey of Youth looked at depression in later life. Dr. Ariel Kalil from the University of Chicago found that unmarried teenage mothers “displayed higher levels of depressive symptoms in young adulthood,” but the psychological health of married teenage mothers in later life was as good as that of married adult mothers.

It appears that unmarried adult mothers and unmarried teenage mothers had similarly poor outcomes. The authors write, “The findings of this study suggest that marital status, rather than age at first birth, may be more relevant for later-life psychological health.”

As for teenage fathers, they may have unrecognized psychological problems, according to a study carried out by Dr. Quinlivan and her team in Melbourne. They write, “It is recognized that pregnant teenagers have higher levels of psychological symptomatology compared to older pregnant women. However, there are limited data on fathers in the setting of teenage pregnancy.”

Interviews carried out with teenage fathers before the birth showed that rates of anxiety and depression were significantly higher than for older fathers. A high anxiety and depression score among these teenage boys was linked to exposure to domestic violence as a child, whereas having their own father alive was significantly protective against anxiety and depression.

Another study by the same team found that teenage fathers tended to have experienced parental separation or divorce in early childhood, and have a higher rate of illicit drug use. The experts say these fathers may lack a positive role model for parenting and fatherhood. The researchers call for more mental health services aimed at teenage fathers.